The saying ‘Tell me how you will measure me and I will tell you how I will behave’ could have been the perfect tag line for the US Health Care Reforms. When we look at how Health Care Information technology is getting used to enable reforms, we see that most of the technologies existed prior to the reforms, but there wasn’t a compelling reason to adopt it. Once the measurement criteria, the carrots and the sticks were defined, the behaviors changed, and to achieve the metrics, the technology adoption picked up. As an example, according to CDC’s report, the adoption of office based physicians with EHR systems has increased to 78.4% in 2013 from 17.3% in 2003.

Percentage of office based physicians with EHR systems in US

Maybe a coincidence, but the Health Care reforms and Health Care Internet of Everything (IoE) are very much intertwined. The Health Care reforms focus on the ‘why’ and ‘what’ changes are needed to enable outcomes and define how performance is measured. The Health Care Internet of Everything focuses on how technology can be leveraged to enable the goals of Health Care Reforms. By connecting the unconnected, IoE brings more information from multiple sources (things and people) to create an enhanced evidence based model to enable better outcomes.

From an IT perspective, Health Care Reforms requires breaking boundaries, opening up the access, enabling choices, improving data collection from multiple critical sources, and enabling information sharing. It is definitely a challenge to achieve these needs using the traditional approaches in Health Care. Hence Health Care approaches have evolved to leverage Health care IT as a change agent, thereby resulting in many new Health Care IT transitions.

Let us explore six key Health Care IT transitions that have significant security implications.

In the past, they were called ‘Patients’, today their mindset and their behavior patterns have changed; they are called ‘Consumers’ of healthcare. They just don’t look at healthcare to consume the services when they are sick, but see it as a means to help them maintain their wellness and remain healthy. They want to be in the driver’s seat, and they want to be empowered and be part of the care decisions.

The Health Care Reforms and Health Care Internet of Everything(IoE) have accelerated the adoption of ‘consumer like’ behavior. From its focus on increased access to care and information, prevention and wellness, the meaningful use criteria calls for specific metrics such as the need for at least 5% of patients to send secure messages to providers. These have accelerated the use of patient portals and mobile apps and wellness devices. According to a report by Research and Markets, the mobile health market is expected to reach $26 billion in revenue by 2017.

Earlier this week, I was presenting at a security conference, the SecConX conference 2014 on the subject ‘At the Security Crossroads of Health Care Reforms and IoE enabled e-health’. I started off the presentation with a slide with three questions to gauge the audience’s adoption of consumer grade fitness devices, patient portal and mobile apps.

Part 1: Why we need to consider virtual care as part of our strategy for pandemic preparedness

Part 2: How virtual care can enable the process transformations to enable business continuity while mitigating the risk of exposure to staff and patients.

In this part, we ask the question: Why Cloud?

When it comes to preparing for a pandemic, there are many unknowns; however, three things are very difficult to precisely predict:

Timing: When will the next Pandemic happen?

Impact: Who will be affected and how much disruption can happen?

Geographical spread: Where will the outbreak happen and spread?

When the scope is unclear, it is always very difficult to plan well. When we look at the options in front of us, we have mainly two options

Commit infinite resources to address the worst case

Leverage a model that can scale based on the need

Obviously, the first option is not a practical business solution. With option 2 being the default approach, this is where the agility of the cloud comes handy. While cloud provides many advantages, let us look at some of the key benefits of cloud when it comes to preparing for a pandemic. They are:

The Convenience of the Cloud:

As we saw in the last part, navigating around the path of the virus can be achieved by using virtual care. Cloud based solutions provide the convenience of accessing services from anywhere, anytime, from any device without having to pre-install. Patients can leverage SaaS based Virtual care solutions to interact with the care teams without leaving their home. New work flows can be pushed out quickly to enable Self-service and dynamic process changes. Read More »

We continue our journey from where we left on part 1 of this series on leveraging Cloud based virtual care in our strategy for pandemic preparedness.

As the news of the pandemic outbreaks occurs, and as patients start seeing flu like symptoms, it’s natural for patients to show up in hospitals and urgent care centers. The care givers that the patients with flu interact are at higher risk of exposure. The US occupational safety and health administration (OSHA) has classified healthcare workplaces to be at very high or high exposure risk for pandemic influenza. For example, a personal that is collecting specimens from pandemic patients is at a very high risk of exposure.

Path of the Virus: Touch points where the healthcare staff is at risk of exposure in a traditional care model

According to CDC guidance, People with flu can spread it to others up to about 6 feet away through droplets made when people with flu cough, sneeze or talk. So proximity and in person interactions must be managed carefully while services are provided.

If we were to track the imaginary path of the flu virus (as a person with flu travels to various places in a hospital), every interaction he has with a staff in person is a potential touch point where he can spread flu. It could be the parking lot, the lobby where he might be passing through healthy visitors, care givers or other patients, the staff at the registration/check-in desk, the nurse or the doctor in the examination room, the staff in the lab, the checkout desk, and list goes on.

Now, let’s look at how virtual care technology driven strategies can help reduce the risk of exposure and at the same time provide essential services to patients. Here are few approaches: Read More »

I was thinking the seasonal flu for the year was almost over, and then last week, I get flu. While looking at the CDS fluview, it continues to report a downward trend in its week 11 reports. Most of the states have almost had turned green, expect for Texas, and I just happened to be lucky in Texas.

When we carefully look at the trends of current seasonal flu based on the Influenza positive tests results reported to CDC, it shows that the last 2 months of 2013 had an upward trend and peaked at the end of the year and the downward trend started in the early weeks of year 2014.

Now, for a second, let’s think: what happens if the trend didn’t take a downward trend, but kept trending upwards – one of the typical situations that differentiate an epidemic or pandemic with a seasonal flu trend.

Pandemic is an epidemic occurring over a very wide area affecting large number of people. This can happen when new strains emerge for which people have very less resistance and there are no ready made vaccines available and hence the disease spreads while preventive and medical care is developed to overcome the situation.

According to flu.gov, each flu season, nearly 111 million workdays are lost due to the flu, amounting to approximately $7 billion per year in sick days and lost productivity. A pandemic could cause not just the financial cost of lost productivity, but also result in wide spread loss of life if not managed well.

While predicting the exact time for the next pandemic is impossible, preparing for one is an absolute must for businesses and communities to ensure the health of employees and citizens. WHO and CDC lead the effort in providing recommendations and checklists for pandemic preparedness.

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